For persons who have cancer of the esophagus, treatment options often include surgery or radiation therapy, sometimes with chemotherapy, depending on the stage (or extent) of disease. Researchers at Fox Chase Cancer Center recently reported that the use of radiation therapy and chemotherapy can be curative for some persons with early-stage disease, and can provide relief from symptoms and prolongation of survival time for those with advanced disease.
Cancer of the esophagus is characterized by the presence of cancerous cells in the esophagus, the tube that connects the throat to the stomach. There are different types of cancer of the esophagus, including
squamous cell cancer and
adenocarcinoma. The treatment of esophageal cancer depends on the type and stage of disease. Cancer that has spread outside the esophagus, but not to other parts of the body, is referred to as
locally advanced cancer. Cancer that has spread to other parts of the body is called
metastatic cancer. Researchers continue to develop and study new chemotherapy drugs and combinations to improve the effectiveness of treatment and to provide greater relief from disease symptoms, enhanced quality of life, and prolonged survival time for persons with cancer of the esophagus.
The researchers treated 57 persons with stage I or II cancer of the esophagus and 33 persons with stage III or IV cancer of the esophagus with radiation therapy and chemotherapy with mitomycin. These patients did not undergo surgery. The results showed that 12% of patients suffered severe side effects early in the treatment, while 3% were hospitalized for side effects occurring late in the treatment. There were no treatment-related deaths. The average survival time for patients with stage III disease was 9 months, and for those with stage IV disease, 7 months. Seventy-seven percent of these persons were able to swallow normally after the treatment, and 60% were still able to swallow without difficulty up until the time of their death. For persons with stage I and II disease, the 3-year survival rates were 73% and 33%, respectively.
These researchers concluded that the combination of radiation therapy and chemotherapy may be curative for a fraction of persons with stage I or II esophageal cancer, and can provide symptom relief, particularly from difficulty with swallowing, for persons with more advanced disease. Individuals with esophageal cancer may wish to talk with their doctor about the risks and benefits of receiving radiation therapy/chemotherapy combination or of participating in a clinical trial in which other promising new treatment regimens are being studied. Sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute
International Journal of Radiation Oncology Biology and Physics, Vol 1, pp 29-36, 1991)